A patient is admitted for acute renal failure and the nurse is monitoring their response to medications. Which pharmacokinetic principle does the nurse understand will most likely be affected in this patient?
Elimination
Metabolism
Distribution
Absorption
The Correct Answer is A
Choice A reason: Elimination is the process of removing a drug from the body, usually through the kidneys or the liver. Acute renal failure is a condition where the kidneys suddenly lose their ability to filter waste products and excess fluid from the blood. This can impair the elimination of drugs that are mainly excreted by the kidneys, leading to increased drug levels and potential toxicity. The nurse should monitor the patient's renal function and adjust the dose of drugs that are renally eliminated.
Choice B reason: Metabolism is the process of transforming a drug into one or more metabolites, usually by enzymes in the liver. Acute renal failure does not directly affect the metabolism of drugs, unless it causes liver damage or alters the blood flow to the liver. The nurse should monitor the patient's liver function and the levels of drugs that are metabolized by the liver.
Choice C reason: Distribution is the process of transferring a drug from the blood to the tissues and organs of the body. Acute renal failure can affect the distribution of drugs that are bound to plasma proteins, such as albumin. When the kidneys are damaged, they may leak protein into the urine, causing hypoalbuminemia (low levels of albumin in the blood). This can increase the amount of free or unbound drug in the blood, which may enhance the drug's effect or cause adverse reactions. The nurse should monitor the patient's serum albumin level and the effects of drugs that are highly protein bound.
Choice D reason: Absorption is the process of moving a drug from the site of administration to the bloodstream. Acute renal failure does not directly affect the absorption of drugs, unless it causes changes in the gastrointestinal tract, such as edema, bleeding, or motility disorders. The nurse should monitor the patient's gastrointestinal function and the bioavailability of drugs that are administered orally.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This choice is incorrect because insulin is not commonly given to all hospitalized clients. Insulin is a hormone that lowers blood sugar levels in the body. It is only given to clients who have diabetes or other conditions that cause high blood sugar, such as pancreatitis, sepsis, or steroid therapy. The nurse should explain the indication and purpose of insulin to the client and not make false or misleading statements.
Choice B reason: This choice is incorrect because the client did not likely develop diabetes prior to hospitalization, but are just now being diagnosed. Diabetes is a chronic condition where the body either does not produce enough insulin or does not use it properly, resulting in high blood sugar levels. Diabetes can be diagnosed by measuring the blood sugar levels, the hemoglobin A1c levels, or the oral glucose tolerance test. The nurse should not assume or imply that the client has diabetes without proper testing and confirmation.
Choice C reason: This choice is incorrect because the client did not develop type 1 diabetes and will not need insulin for the rest of their life. Type 1 diabetes is an autoimmune condition where the body destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin. Type 1 diabetes usually develops in childhood or adolescence, and requires lifelong insulin therapy. The nurse should not diagnose or predict the client's condition without evidence or authority.
Choice D reason: This choice is correct because glucocorticoid steroid medications can cause temporary hyperglycemia. Glucocorticoids are anti-inflammatory drugs that suppress the immune system and reduce inflammation. They are used to treat conditions such as multiple sclerosis, asthma, rheumatoid arthritis, and allergic reactions. However, they can also increase the blood sugar levels by stimulating the liver to produce more glucose and reducing the sensitivity of the cells to insulin. The nurse should inform the client that the insulin is needed to control the blood sugar levels while they are on steroid therapy, and that the insulin dose may be adjusted or discontinued when the steroids are tapered or stopped.
Correct Answer is ["0.04"]
Explanation
To calculate the amount of exenatide 10 mcg needed from a concentration of 250 mcg/mL, we can use the following formula:
Amount (mL) = (Desired dose in mcg) / (Concentration in mcg/mL)
Plugging in the values:
Amount (mL) = 10 mcg / 250 mcg/mL
Calculating:
Amount (mL) = 0.04 mL
Rounding to the nearest hundredth:
Amount to administer = 0.04 mL
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